Evidence map›Paper›PMID 31787107›Full record

Observational studyBMC family practice2019

To what degree do patients actively choose their healthcare provider at the point of referral by their GP? A video observation study.

Amy J C Potappel, Maartje C Meijers, Corelien Kloek, Aafke Victoor, Janneke Noordman, Tim Olde Hartman, Sandra van Dulmen, Judith D de Jong

Abstract readObservational Study
In one paragraph

Observational study in BMC family practice, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. A Bibliometric Analysis and Visualization of Decision Support Systems for Healthcare Referral Strategies.International journal of environmental research and public health · 2022
    Pooled it
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Amy J C PotappelNivel (Netherlands institute for health services research), Utrecht, Netherlands.
Maartje C MeijersNivel (Netherlands institute for health services research), Utrecht, Netherlands.
Corelien KloekNivel (Netherlands institute for health services research), Utrecht, Netherlands.
Aafke VictoorNivel (Netherlands institute for health services research), Utrecht, Netherlands. a.victoor@nivel.nl.ORCID 0000-0003-2645-8872
Janneke NoordmanNivel (Netherlands institute for health services research), Utrecht, Netherlands.
Tim Olde HartmanDonders Institute for Brain Cognition and Behaviour, Radboudumc Nijmegen, Nijmegen, Netherlands.
Sandra van DulmenNivel (Netherlands institute for health services research), Utrecht, Netherlands.
Judith D de JongNivel (Netherlands institute for health services research), Utrecht, Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMany countries in Europe have implemented managed competition and patient choice during the last decade. With the introduction of managed competition, health insurers also became an important stakeholder. They purchase services on behalf of their customers and are allowed to contract healthcare providers selectively. It has, therefore, become increasingly important to take one's insurance into account when choosing a provider. There is little evidence that patients make active choices in the way that policymakers assume they do. This research aims to investigate, firstly, the role of patients in choosing a healthcare provider at the point of referral, then the role of the GP and, finally, the influence of the health insurer/insurance policies within this process.

methodsWe videotaped a series of everyday consultations between Dutch GPs and their patients during 2015 and 2016. In 117 of these consultations, with 28 GPs, the patient was referred to another healthcare provider. These consultations were coded by three observers using an observation protocol which assessed the role of the patient, GP, and the influence of the health insurer during the referral.

resultsPatients were divided into three groups: patients with little or no input, patients with some input, and those with a lot of input. Just over half of the patients (56%) seemed to have some, or a lot of, input into the choice of a healthcare provider at the point of referral by their GP. In addition, in almost half of the consultations (47%), GPs inquired about their patients' preferences regarding a healthcare provider. Topics regarding the health insurance or insurance policy of a patient were rarely (14%) discussed at the point of referral.

conclusionsJust over half of the patients appear to have some, or a lot of, input into their choice of a healthcare provider at the point of referral by their GP. However, the remainder of the patients had little or no input. If more patient choice continues to be an important aim for policy makers, patients should be encouraged to actively choose the healthcare provider who best fits their needs and preferences.

Indexed as

Choice BehaviorGeneral PractitionersReferral and ConsultationFemaleHumansInsurance, HealthMaleMiddle AgedNetherlandsPatient PreferencePatientsVideo RecordingCommunicationGeneral practitionersHealthcare providersHealthcare reformHealth insuranceHealth insurerPatient choicePhysicians’ roleReferral

Identifiers

PMID31787107
PMCPMC6885306

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.